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Impact of smoke-free legislation on cigarette price and affordability in Wuhan, China: a repeated cross-sectional study
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DOI：10.1186/s12889-026-28693-3.png)
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Abstract
En 中文
The smoke-free legislation (SFL) in Wuhan, China was adopted in January 2020. While its health benefits are documented, the impact on cigarette prices and affordability among smokers remains unclear. This study assessed the impact of Wuhan’s SFL on cigarette prices and affordability. Three rounds of repeated cross-sectional surveys were conducted in 2019 (pre-legislation), 2022 and 2024 (post-legislation), following the Global Adult Tobacco Survey (GATS) protocol. A multistage cluster sample design selected representative samples of non-institutionalized permanent residents aged ≥ 15 years. Analysis was restricted to current manufactured cigarette smokers. Cigarette prices were adjusted for inflation and purchasing power parity (PPP) to constant 2024 US dollars. Cigarette affordability was measured as the average cost of 100 packs as a percentage of GDP per capita. Complex sampling designs, ordered logit models and marginal effects analyses were employed. A total of 8,424 participants were interviewed, with response rates of 94.5% (2019), 92.8% (2022) and 100% (2024). The average amount spent on 20 cigarettes did not change significantly from $5.3 (95%CI: 4.7–5.8) in 2019 to $5.2 (95%CI: 4.2–5.9) in 2024. A wide price range persisted, with mean prices in the lowest quintile ranging from $1.88 to $3.73 and in the highest quintile from $10.72 to $13.60. Cigarette affordability increased significantly. The cost of 100 packs as a percentage of GDP per capita decreased from 2.8% (95%CI: 2.5–3.1) in 2019 to 2.2% (95%CI: 1.8–2.5) in 2024. Compared to 2019, the odds of being in the higher-affordability category increased by 18.2% points in 2024 (p < 0.05). The overall odds of choosing different price-tiers did not change significantly. Smokers who were male, younger (15–24 years), highly educated (college and above), employed in government/corporate sectors, or had no intention to quit had higher odds of choosing upper price-tier cigarettes and having higher cigarette affordability. Following SFL implementation in Wuhan, cigarette prices remained stable while affordability increased significantly. The wide price range enables potential substitution to cheaper brands. SFL alone is insufficient to curb consumption. National tobacco control legislation should integrate robust tax and floor pricing policies.
Keywords:
Cigarette price
Cigarette affordability
Secondhand smoke (SHS) exposure
Tobacco control
Smoke-free legislation (SFL)
Public places
Wuhan, china
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